Provider Demographics
NPI:1891199782
Name:CARE FOR WOMEN JOPLIN LLC
Entity Type:Organization
Organization Name:CARE FOR WOMEN JOPLIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:TYRONE
Authorized Official - Last Name:ADCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:417-623-1222
Mailing Address - Street 1:PO BOX 3027
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-3027
Mailing Address - Country:US
Mailing Address - Phone:417-623-1222
Mailing Address - Fax:
Practice Address - Street 1:3201 MCINTOSH CIR
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3647
Practice Address - Country:US
Practice Address - Phone:417-623-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty